Name:

Madison Address:
Enter your Madison address here

Madison Phone:

Permanent Address (if different):
Enter a permanent address if different from above

Permanent Phone:

Your e-mail address:

1) Number of hours wanted per week:

2) Indicate your availability to work these specific shifts:
Early a.m.: Midnight - 8 a.m. ($11/hour)
Early a.m.: 7:30 a.m. - 11:00 a.m.
11:00 a.m. - 2:00 p.m.
Midnight - 3:00 a.m. ($11/hour)

3) Please fill in your FALL class schedule. Include any other times that you CANNOT work.

4) If offered employment here, do you agree to give two weeks notice if you decide to end your employment here and to work shifts that do not conflict with exams during exam periods?:
Yes  No

5) Do you have a Work Study Grant (a type of financial aid that is sometimes offered)?:
Yes  No

6) Number of semesters remaining as a UW student:

7) What type of computer do you use more?:
Windows  Macintosh  Both Equally

8) How frequently do you use Macintosh computers?:
Not At All  Occasionally  Extensively

9) How frequently do you use computers running Windows XP?:
Not At All  Occasionally  Extensively

10) Indicate your level of knowledge of the following Windows applications:

11) Indicate your level of knowledge of the following Macintosh applications:

12) List any jobs you have held that involved helping others:
Tell us about your experience helping others

13) Please give your reasons for wanting to work here:
Tell us why you want to work here

14) List any other relevant experience (work or otherwise)?
Tell us about any other relevant experience you have

Thanks for your interest.